Risk Factors For Distal Symmetric Neuropathy in NIDDM: The San Luis Valley Diabetes Study

Franklin, Gary M.; Shetterly, Susan; Cohen, Jeffrey A.; Baxter, Judith; Hamman, Richard F.

doi:10.2337/diacare.17.10.1172

Cited by 84 publications

(70 citation statements)

References 22 publications

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“…Finally, Young et al showed a higher grading of retinopathy for those consuming more than ten alcoholic drinks per week compared with those drinking less than ten drinks per week [9]. For neuropathy, Franklin et al observed an odds ratio of 0.71 for moderate consumers of 0 to 20 g per week, which was similar to our results [10]. Tesfaye et al [11], on the other hand, did not find an association, but detailed results of this analysis were not reported.…”

Section: Discussionsupporting

confidence: 90%

“…Of the invited patients, 85% took part in the study. Patients were stratified by sex, age (15-29, 30-44 and 45-60 years) and duration of illness (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14), ≥15 years) before ten patients were randomly selected from each stratum. Ethics committee approval was obtained at each centre and all participants provided written informed consent.…”

Section: Methodsmentioning

confidence: 99%

“…Three of these assessed the effect of alcohol consumption on retinopathy with inconsistent results ranging from an inverse relation, no relation and a positive association [7][8][9]. Two cross-sectional studies showed no relation between alcohol consumption and the incidence of neuropathy [10,11], although the incidence of neuropathy was higher in heavy drinkers according to a small cross-sectional study [12]. Finally, another cross-sectional study among 998 patients reported a decreased risk of microalbuminuria for light drinkers [13].…”

Section: Introductionmentioning

confidence: 99%

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Alcohol consumption and risk of microvascular complications in type 1 diabetes patients: the EURODIAB Prospective Complications Study

et al. 2008

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Aims/hypothesis The aim of this study was to investigate the association between alcohol consumption and risk of microvascular complications (retinopathy, neuropathy, nephropathy) in type 1 diabetes mellitus patients in the EURODIAB Prospective Complications Study. Methods The EURODIAB Prospective Complications Study is a follow-up study including 3,250 type 1 diabetes mellitus patients from 16 different European countries. We investigated the cross-sectional association between moderate alcohol consumption and risk of retinopathy, neuropathy and nephropathy among 1,857of these patients. Results We documented 304 cases of proliferative retinopathy, 660 cases of neuropathy and 157 cases of nephropathy (macroalbuminuria). Alcohol consumption was associated with risk of proliferative retinopathy, neuropathy and macroalbuminuria in a U-shaped fashion. Moderate consumers (30-70 g alcohol per week) had a lower risk of microvascular complications with odds ratios of 0.60 (95% CI 0.37-0.99) for proliferative retinopathy, 0.61 (0.41-0.91) for neuropathy and 0.36 (0.18-0.71) for macroalbuminuria in multivariate-adjusted models. These results were similar when excluding patients who had been advised to drink less alcohol because of their health. The relation was most pronounced for alcohol consumption from wine. Drinking frequency was significantly, inversely associated with risk of neuropathy, but a similar trend was visible for proliferative retinopathy and macroalbuminuria. Alcohol consumption was not associated with occurrence of ketoacidosis or hypoglycaemic attacks. Conclusions/interpretation Consistent with its effects on macrovascular complications, moderate alcohol consumption is associated with a lower risk of all microvascular complications among type 1 diabetes patients.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Alcohol consumption and risk of microvascular complications in type 1 diabetes patients: the EURODIAB Prospective Complications Study

et al. 2008

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“…However, there was a drop in the 61-70 years age group and the reason was not known. As compared to the findings of previous studies, in our study, the prevalence of PIN increased as the age advanced, irrespective of the diabetic status [1][2][3][4][5][6][7][8][9]16,20,21]. The attribution of the increase in age for PIN may be because of the decreased nerve fibres, a reduction in the nerve diameter and changes in the fibre membrane and the conduction velocity {(Huang CR et al,) [22],(Chu NS et al,) [23].…”

Section: Discussionsupporting

confidence: 61%

Peripheral Insensate Neuropathy- Is Height a Risk Factor?

Kote

Bhat²,

Thajuddeen

et al. 2013

JCDR

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Introduction: Peripheral insensate neuropathy is one of the most commonest and the earliest forms of peripheral neuropathy. It is one of the leading causes of the disability in working population who are at risk. Methods:A study was conducted in Kasturba medical college (Manipal university) in the year 2009-12, which included examination of 818 people of more than 30yrs of age by random sampling method who were attending the outpatient clinic. A monofilament was used to determine the peripheral insensate neuropathy, which was defined by the presence of one or more insensate areas. Results:In our study , the prevalence of peripheral insensate neuropathy was 16.2 % ( p-0.0001), among which 9.7% were males and 7.5% were females. The males were 1.27 times significantly at a higher risk than the females , even after a height adjustment to the gender difference in height. As the height increased, the prevalence of peripheral insensate neuropathy increased, irrespective of the diabetic and hypertensive statuses. The risk of the peripheral insensate neuropathy increases at a height of >167 cm in males and at a height of >159 cm in females. Conclusion:The authors conclude that body height is an important and an independent risk factor for peripheral insensate neuropathy, irrespective of co morbidities. Height as a marker, helps the health care professionals in identifying the people who are at risk for peripheral insensate neuropathy.G S Sharath Kote, ajay N Bhat, thajuddeeN K, MohaMMed h ISMaIl, aBhISheK Gupta InTROduCTIOnPeripheral insensate neuropathy is defined as the presence of one or more insensate areas [1]. It is a common problem which is encountered in middle and old aged people. It is one of the disabling complications of diabetes because of its high incidence and its potential to lead to lower extremity ulceration, deformation and amputation [2]. Many factors have been associated with neuropathy, like age, sex, race, glycaemic control, nutrition, toxin exposure, drugs, alcohol, etc [1,3,4].Peripheral neuropathy affects 2-8% of the adults and it increases with age. With an early detection and history taking and focused laboratory tests, the underlying cause can be identified in ~75% of the cases. The prevalence of neuropathy is 66% for type 1 diabetes and it is 59% for type 2 diabetes. In a population cohort of diabetic patients, two third of the diabetics had an objective evidence of neuropathy, mainly a loss of the foot sensation, but only 15% of the IDDM cases and 13% of the NIDDM cases were symptomatic. Peripheral neuropathy can occur before the onset of clinically detectable Diabetes mellitus (DM) [5].Height is an important and a practical predictor of peripheral insensate neuropathy. As the height increases, the lengths of the nerve fibers also increase and so the surface area of the axons is available for the toxin exposure and the physical damage is more. So, the risk of peripheral insensate neuropathy increases with an increase in height. Many studies have shown the corelation of height with p...

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“…However, studies assessing the effects of exercise training in long-standing, insulin-treated, T2D patients with complications are generally lacking. The latter is partly due to the many difficulties encountered when trying to define an appropriate exercise programme for these patients, who generally suffer from substantial weight gain (5), exercise intolerance and diabetic polyneuropathy (6)(7)(8). The level of diabetic polyneuropathy also appears to be associated with general muscle weakness (9,10), impaired physical performance (11), poor glycemic control (12) and a high cardiovascular risk profile (13).…”

Section: Introductionmentioning

confidence: 99%

Long-standing, insulin-treated type 2 diabetes patients with complications respond well to short-term resistance and interval exercise training

Praet¹,

Jonkers²,

Schep³

et al. 2008

European Journal of Endocrinology

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Objective: To determine the feasibility and the benefits of combined resistance and interval exercise training on phenotype characteristics and skeletal muscle function in deconditioned, type 2 diabetes (T2D) patients with polyneuropathy. Design: Short-term, single-arm intervention trial. Methods: Eleven male T2D patients (age: 59.1G7.5 years; body mass index: 32.2G4.0 kg/m 2 ) performed progressive resistance and interval exercise training thrice a week for 10 weeks. Besides primary diabetes outcome measures, muscle strength (MUST), maximal workload capacity (W max ), whole-body peak oxygen uptake (VO 2peak ) and muscle oxidative capacity (MUOX), intramyocellular lipid (IMCL) and glycogen (IMCG) storage, and systemic inflammation markers were determined before and after training. Daily exogenous insulin requirements (EIR) and historic individualized EIR were gathered and analysed. Results: MUST and W max increased with 17% (90% confidence intervals 9-24%) and 14% (6-21) respectively. Furthermore, mean arterial blood pressure declined with 5.5 mmHg (K9.7 to K1.4). EIR dropped with 5.0 IU/d (K11.5 to 1.5) compared with baseline. A decline of respectively K0.7 mmol/l (K2.9 to 1.5) and K147 mmol/l (K296 to 2) in fasting plasma glucose and non-esterified fatty acids concentrations were observed following the intervention, but these were not accompanied by changes in VO 2peak , MUOX, IMCL or IMCG, and blood glycolysated haemoglobin, adiponectin, tumor necrosis factor-a and/or cholesterol concentrations. Conclusion: Short-term resistance and interval exercise training is feasible in deconditioned T2D patients with polyneuropathy and accompanied by moderate improvements in muscle function and blood pressure. Such a specific exercise regimen may provide a better framework for future exercise intervention programmes in the treatment of deconditioned T2D patients.

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Risk Factors For Distal Symmetric Neuropathy in NIDDM: The San Luis Valley Diabetes Study

Cited by 84 publications

References 22 publications

Alcohol consumption and risk of microvascular complications in type 1 diabetes patients: the EURODIAB Prospective Complications Study

Alcohol consumption and risk of microvascular complications in type 1 diabetes patients: the EURODIAB Prospective Complications Study

Peripheral Insensate Neuropathy- Is Height a Risk Factor?

Long-standing, insulin-treated type 2 diabetes patients with complications respond well to short-term resistance and interval exercise training

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